AFFIDAVIT AND AGREEMENTAffidavit and Agreement • February 12th, 2013
Contract Type FiledFebruary 12th, 2013I, , residing at the undersigned member (the words "I", "me", or "my" in this document refer to the member) of the Bethpage Federal Credit Union (the "Credit Union") do hereby request that payment be stopped on the following official check: